Provider Demographics
NPI:1295320836
Name:PHIPPS PHARMACY INC
Entity type:Organization
Organization Name:PHIPPS PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:PHIPPS
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:731-352-0820
Mailing Address - Street 1:205B HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:MC KENZIE
Mailing Address - State:TN
Mailing Address - Zip Code:38201-1649
Mailing Address - Country:US
Mailing Address - Phone:731-352-0820
Mailing Address - Fax:731-352-2848
Practice Address - Street 1:19 HUGHES DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-1510
Practice Address - Country:US
Practice Address - Phone:731-668-9072
Practice Address - Fax:731-664-9760
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PHIPPS PHARMACY INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-03-05
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy